Legal Name *

First Name

Last Name

Phone *

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At which location do you wish to do your community service?

Titusville Thrift Store (Open 9 a.m. - 6 p.m. Monday through Saturday and 10 a.m. - 5 p.m. on Sunday)

Melbourne Thrift Store (Open 9 a.m. - 6 p.m. Monday through Saturday and Closed on Sunday)

Adoption Center (We have very limited community service spaces available here)

Please read carefully before checking the box and submitting your application:

I understand and agree that submitting this application form does not automatically register me as an SPCA of Brevard Community Service Worker and that there may be certain qualifications I must meet, including the acceptance of established policies and procedures before I begin. I understand that I will not be allowed to handle animals at the SPCA unless specifically asked to by staff and that the bulk of my community service will be geared toward cleaning kennels and general upkeep of the adoption center. By submitting this form, I attest that the information I have provided on the form is true. I agree to hold harmless the SPCA of Brevard, its employees, directors and insurance carriers from any and all claims, damages and judgements which I may have now or in the future against the SPCA of Brevard in all matters pertaining to my service as an SPCA of Brevard Community Service Worker.

I agree